Angioplasty

What is a Stent

Stent

When a coronary artery (an artery feeding the heart muscle) is narrowed by a buildup of fatty deposits called plaque, it can reduce blood flow. If blood flow is reduced to the heart muscle, chest pain can result. If a clot forms and completely blocks the blood flow to part of the heart muscle, hearts attack results. A stent is a small mesh tube that’s used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called Percutaneous  Coronary Intervention (PCI), sometimes referred to as coronary angioplasty.  Stents help keep coronary arteries open and reduce the chance of a heart attack.

How Stent Works

Angioplasty

To open a narrowed artery, a doctor may do a procedure called a percutaneous coronary intervention (PCI) or angioplasty. In it, a balloon-tipped tube (catheter) is inserted into an artery and moved to the point of blockage. Then the balloon is inflated. This compresses the plaque and opens the narrowed spot. When the opening in the vessel has been widened, the balloon is deflated and the catheter is withdrawn.

Advantages of Stents

The stent holds the coronary artery open. The uses of stents are as follows:

  1. Patients who have angioplasty and stents recover from these procedures much faster than patients who have coronary artery bypass surgery (CABG).
  2. Improve blood flow to the heart muscle.
  3. Relieve the symptoms of coronary artery disease
  4. Reduce the chance of the blockage returning.

The procedure may be done in an emergency, such as during an episode of angina or a heart attack.

Procedure for Angioplasty

An angioplasty normally takes between 30 minutes and two hours, although it can take longer.

  1. At the start of the procedure you’ll be given a local anaesthetic to numb the area. Then a catheter – a fine, flexible, hollow tube – with a small inflatable balloon at its tip is passed into an artery in either your groin or your arm.
  2. Some dye (contrast) is injected into the catheter and the arteries can be seen on an x-ray screen. It’s normal to feel a hot flushing sensation when the dye is injected.
  3. The operator then directs the catheter up to the heart and into a coronary artery until its tip reaches a narrow or blocked section.
  4. The balloon is then gently inflated so that it squashes the fatty plaques – or deposits – against the artery wall, widening the artery and allowing the blood to flow more easily.
  5. A stent – a small tube of stainless steel mesh – is already in place on the balloon. As the balloon is inflated, the stent expands so that it holds open the narrowed artery. The balloon is let down and removed, leaving the stent in place.
  6. Some people may feel a palpitation, and you might feel some angina. If you feel unwell, or have pain at any time during the procedure, tell the team.
  7. When the test is over, the catheters are removed. Sometimes there might be a small amount of bleeding when they are taken out. A nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. After the procedure, you’ll need to stay in bed for a while.

 

Precautions after Procedure

Patients who’ve had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. These medications help reduce the risk of a blood clot developing in the stent and blocking the artery.

  1. Aspirin is used indefinitely.
  2.  Clopidogrel is used for one to 12 months (or perhaps even longer) after the procedure (depending on the type of stent). Clopidogrel can cause side effects, so blood tests will be done periodically.
  3. It’s important that you don’t stop taking this medication for any reason without consulting your cardiologist who has been treating your coronary artery disease.
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